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a Rheumatology
Section, b and Nephrology Division, c Hospital de Cruces, Pais Vasco, Spain
Rehabilitation Division, Hospital de Gorliz, Pais Vasco, Spain
Correspondence to: Dr F Perez-Ruiz, Sección de Reumatología, Hospital de Cruces, Pza de Cruces sn, 48903 Barakaldo, Vizcaya, Spain.
Accepted for publication 8 July 1998
OBJECTIVES
To study the efficacy of allopurinol
and benzbromarone to reduce serum urate concentrations in patients with
primary chronic gout.
METHODSProspective, parallel, open study of 86 consecutive male patients with primary chronic gout. Forty nine
patients (26 normal excretors and 23 under excretors) were given
allopurinol 300 mg/day and 37 under excretors benzbromarone 100 mg/day.
After achieving steady plasma urate concentrations with such doses,
treatment was then adjusted to obtain optimal plasmatic urate
concentrations (under 6 mg/dl).
RESULTSPatients receiving allopurinol 300 mg/day
showed a mean reduction of plasmatic urate of 2.75 mg/dl (from 8.60 to
5.85 mg/dl) and 3.34 mg/dl (from 9.10 to 5.76 mg/dl) in normal
excretors and under excretors respectively. Patients receiving
benzbromarone 100 mg/day achieved a reduction of plasmatic urate of
5.04 mg/dl (from 8.58 to 3.54 mg/dl). Fifty three per cent of patients
receiving allopurinol and 100% receiving benzbromarone achieved
optimal plasma urate concentrations at such doses. The patients with
poor results with allopurinol 300 mg/day achieved a proper plasma urate concentration with allopurinol 450 to 600 mg/day, the mean final dose
being 372 mg/day. Renal fuction improved and no case of renal lithiasis
was observed among benzbromarone treated patients, whose mean final
dose was 76 mg/day.
CONCLUSIONBenzbromarone is very effective to
control plasma urate concentrations at doses ranging from 50 to 100 mg/day. Uricosuric treatment is a suitable approach to the treatment of
patients with gout who show underexcretion of urate.
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